More Comorbidities Predict Greater PN Complication Risk

SAN DIEGO—Greater comorbidity burden independently predicts development of medical complications following partial nephrectomy (PN), investigators reported at the American Urological Association annual meeting.

The researchers concluded that the association between CCI and medical complications should be incorporated into the decision-making and counseling of patients with competing medical risks and who present with localized renal tumors.

Jay Simhan, MD, and collaborators at Fox Chase Cancer Center in Philadelphia, studied 512 patients who underwent PN and had a median follow-up of 23 months. Compared with patients who had no complications, those who experienced any complication had a significantly greater nephrometry score, ASA score, estimated blood loss, operative time, and preoperative tumor size. Increasing Charlson Comorbidity Index (CCI) was associated with the development of any complication, any medical complication, and any major medical complications, after controlling for patient and clinical characteristics. The study found no association between CCI and surgical complications.

Study findings were presented by co-investigator Zachary Piotrowsky, MD, a third-year resident at Fox Chase, who observed: “As we operate on more and more complex patients, older patients, with more comorbidities, we can better preoperatively counsel them in terms of their postoperative risk.”

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